Bronchoscopic airway evaluation facilitated by the laryngeal mask airway in pediatric patients

The laryngeal mask airway (LMA) was introduced for clinical use in 1988. It represents a new concept in airway management. Its role has been described as filling the gap between tracheal intubation and the anesthesia face mask. It is inserted without direct visualization into the hypopharynx and when properly positioned forms a low pressure seal around the laryngeal inlet, allowing spontaneous as well as gentle positive pressure ventilation. Since its introduction, its indications and applications in anesthesia practice have increased. Although initially used as a means of delivering anesthesia and obviating the need for holding a mask on the patient, its position directly over the laryngeal inlet makes it a useful guide during flexible bronchoscopy. We report our experience in six pediatric patients and describe an anesthetic technique for bronchoscopy using the LMA for general anesthesia with spontaneous ventilation.